In his 1992 book, "The End of History and the Last Man," Francis Fukuyama argued that democratic liberalism had won, and that man's evolution was reached its highest point. With his new book, Fukuyama, a former State Department official and now a professor at Johns Hopkins, admits that history can't be said to be ended, because we're now able to change the nature of human beings. In so doing, we've changed the assumptions of history to this point. Beliefnet's Paul O'Donnell talked with him recently about the dangers of biotechnology and drugs, and about the four-year moratorium on research cloning recommended this summer by the president's panel on bioethics, on which Fukuyama served.

You say it's important to limit genetic research because "human nature is fundamental to our notions of justice, morality and the good life." How does genetic science threaten our human nature?
We're all connected by certain things we hold in common. Some of the most important are our emotional range, how we react to each other. That's what really connects us morally. To the extent that we begin playing with those essential-not secondary, but essential--human characteristics, we lose touch not just with each other, but all the previous generations of human beings who have existed. We become different kinds of creatures.

Some ethicists, including Princeton's Lee Silver, ask what's wrong with that? Human nature has been self-selected by society in some sense.
I've always wanted to ask Lee Silver, "Would you regard the elimination of a genetic propensity for homosexuality an improvement in a human being, in the manner we select for pest resistance in a corn plant? If he could answer that question simply, I'd say, okay, let's go ahead and do it.

Don't you think our desire for control over genetics is itself human nature?
If that were all that were in our natures, that would be one thing. But we also have emotions about community and solidarity with one another, which require some limits on individual choice. Therefore, simply to say you're going to preserve this one aspect of human nature that wants to maximize our ability to change ourselves privileges one aspect of human nature over another.

So when does this stop being medicine? What's the fear for you?
In the drug world we've gotten past what I regard as legitimate medicine in certain respects with cosmetic pharmacology, overprescribing drugs, like Prozac or Ritalin. In the future, genetic screening that is used for other than therapeutic purposes would be questionable. If you are choosing sex, or you're identifying genetic markers for things that are not clearly diseases, I think that's a problem.

In your book talk about Prozac and Ritalin being used not as medicine but to create socially acceptable behavior. Will reproductive techniques become the Prozac and Ritalin of the future?
It depends discriminating between therapeutic uses of biomedicine and things more in the nature of human enhancements. The big question becomes which is which. The classic case is Ritalin, where you have this socially constructed disease-ADHD-and this very squishy diagnosis about when it exists. People can legitimately question what is an enhancement or an entertainment use of Ritalin.

That's going to come back in genomics. Say we come up dwith something that replaces defective tissue in an 80-year-old, who lives another 10 years, when this person would have died at any other time in human history. It's pretty hard to say that that's not an enhancement use of medicine. There are gray areas, but as a practical matter, it may not be as difficult to make this kind of discrimination as it sounds in theory.

What was your reaction to the report from the Bioethics Committee?
Well, I had a role in drafting it. I support the ban on reproductive cloning and the moratorium on research cloning. I don't think your going to lose that much momentum on the research side because you'll still be doing a lot of the basic research on stem cells on animals, plus there's research going on outside the United States.

Meanwhile, we'll have time to put the regulatory framework in place. In four years we'll know pretty well whether there are not ways of getting the same results through adult stem cells. Some people saw the moratorium as a compromise. In my view it was the right policy. It reflects where the research stands and where the debate in the country stands.

Some griped that the committee was composed of anti-research conservatives. Yet you came out with a report that said, let's wait and see. How did that happen?
Well the initial characterizations were just ridiculous. The media expected Bush to appoint a bunch of pro-life conservatives and he appointed Leon Kass, and Kass appointed a very balanced council. So I think it's a matter of wrong expectations.

It's hard to form expectations about these issues. The pro-life and pro-choice camps don't seem to be dividing neatly. Why is it so hard to predict?
Both on the left and right, biotechnology has created really strange bedfellows. On the left, the pro-environment people are anti-biotech, so that part of the left doesn't support it. Conservatives have an even bigger problem, because there's always been such an alliance between social conservative and free-market libertarians, who are pro-industry and pro-technology. On this issue they can't paper over their differences.

What neither side seems to want to talk about, amid all the debate about the fate of embryos, is that fertility clinics are very actively creating and disposing of embryos.
Virtually every other country besides the United States regulates their IVF industry. The British, who permit research cloning and stem cell research, have fairly strict regulations for their IVF industry. They all have to be licensed and there are all sorts of rules about what they can and can't do.

Part of it is that the FDA statute doesn't permit it to regulate process. It can regulate drugs and medical products, but processes fall out of its sphere. IVF is going to be the launching pad for genetic testing, for genetic discrimination and pre-implantation genetic diagnosis and, if and when the times comes, for germ line engineering. So there is good reason to set up a broader regulatory framework.

But there are a lot of problems. Pro-choice people are going to think this is pro-life people trying to take away an existing freedom. Pro-life people aren't going to like a lot of the specific regulations--like the British law that regulates the destruction of all embryos after 14 days. So politically it's going to be very difficult if not impossible.

Do you think science will eventually outrun these ethical questions?
If you look at the history, technology always outruns regulation, then regulation catches up. They said about information technology that it's borderless and so on, and that turns out to be nonsense. It just takes a while for the political community to educate itself and debate what's going on.

Unfortunately in the history of regulation, most of it has followed on some biggest disaster. It took Thalidomide and other disasters to create the FDA and the current system of oversight. So a combination of the public and legislators catching up with the technology, usually stimulated by some real problem is what's required. It's not a very optimistic scenario, but technology doesn't always stay ahead of regulation.

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